Trends and predictors of HIV-1 acquired drug resistance in Minas Gerais, Brazil: 2002-2012
Autor(a) principal: | |
---|---|
Data de Publicação: | 2017 |
Outros Autores: | , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Repositório Institucional da UFMG |
Texto Completo: | https://doi.org/10.1016/j.bjid.2016.11.009 http://hdl.handle.net/1843/47681 |
Resumo: | Several studies show that the prevalence of multidrug-resistant HIV-1 virus is declining over time. A retrospective cohort study was carried out to evaluate the trends of drug resistance in antiretroviral treatment-exposed individuals in a state of a middle-income country, Minas Gerais, southeast region of Brazil. We analyzed 2115 HIV-1 sequences from 2002 up to 2012, from 52 cities of Minas Gerais. The groups were analyzed according to the definitions: “IAS– 3 class mutations”, if ≥1 drug resistance mutation from IAS 2015 list (DRM) was present in each class; “No fully susceptible drugs” as the absence of any fully susceptible drug in Stanford algorithm; and “GSS ≥ 2", when a maximum calculated GSS (genotypic susceptibilityscore) was ≥2 or ≥3, counting only drugs available in Brazil and USA at given calendar years. Time trends of resistance were analyzed by Cochran–Armitage test. We observed a decrease in the rate resistance mutations for PI, NRTI, “IAS – 3 class mutations”, and “No fully susceptible drugs” over these 11 years, from 69.2% to 20.7%, 92.3% to 90.2%, 46.2% to 22.5%, and 12.8% to 5.7%, respectively (p < 0.05). Resistance to NNRTI increased from 74.4% to 81.6%, mainly because of K103N mutation. The GSS score ≥2 increased during the years from 35.9% to 87.3% (p < 0.001). We demonstrate that resistance to PI and to the three main classes simultaneously are declining, although the number of patients on of antiretroviral therapy has doubled in the last ten years in Brazil (125,000 in 2002 to 400,000 in 2014). Broader resistance testing and the availability of more therapeutic options might have influenced this decline. The increase in NNRTI resistance can limit this class as first line treatment in Brazil in the future. |
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2022-12-02T00:12:38Z2022-12-02T00:12:38Z2017212148154https://doi.org/10.1016/j.bjid.2016.11.00916784391http://hdl.handle.net/1843/476810000-0001-6833-3870Several studies show that the prevalence of multidrug-resistant HIV-1 virus is declining over time. A retrospective cohort study was carried out to evaluate the trends of drug resistance in antiretroviral treatment-exposed individuals in a state of a middle-income country, Minas Gerais, southeast region of Brazil. We analyzed 2115 HIV-1 sequences from 2002 up to 2012, from 52 cities of Minas Gerais. The groups were analyzed according to the definitions: “IAS– 3 class mutations”, if ≥1 drug resistance mutation from IAS 2015 list (DRM) was present in each class; “No fully susceptible drugs” as the absence of any fully susceptible drug in Stanford algorithm; and “GSS ≥ 2", when a maximum calculated GSS (genotypic susceptibilityscore) was ≥2 or ≥3, counting only drugs available in Brazil and USA at given calendar years. Time trends of resistance were analyzed by Cochran–Armitage test. We observed a decrease in the rate resistance mutations for PI, NRTI, “IAS – 3 class mutations”, and “No fully susceptible drugs” over these 11 years, from 69.2% to 20.7%, 92.3% to 90.2%, 46.2% to 22.5%, and 12.8% to 5.7%, respectively (p < 0.05). Resistance to NNRTI increased from 74.4% to 81.6%, mainly because of K103N mutation. The GSS score ≥2 increased during the years from 35.9% to 87.3% (p < 0.001). We demonstrate that resistance to PI and to the three main classes simultaneously are declining, although the number of patients on of antiretroviral therapy has doubled in the last ten years in Brazil (125,000 in 2002 to 400,000 in 2014). Broader resistance testing and the availability of more therapeutic options might have influenced this decline. The increase in NNRTI resistance can limit this class as first line treatment in Brazil in the future.Vários estudos mostram que a prevalência do vírus HIV-1 multirresistente está diminuindo com o tempo. Um estudo de coorte retrospectivo foi realizado para avaliar as tendências de resistência a medicamentos em indivíduos expostos ao tratamento antirretroviral em um estado de um país de renda média, Minas Gerais, região sudeste do Brasil. Foram analisadas 2.115 sequências de HIV-1 de 2002 a 2012, de 52 cidades de Minas Gerais. Os grupos foram analisados de acordo com as definições: “IAS– 3 classes de mutações”, se ≥1 mutação de resistência a medicamentos da lista IAS 2015 (DRM) estava presente em cada classe; “Nenhum medicamento totalmente suscetível” como a ausência de qualquer medicamento totalmente suscetível no algoritmo de Stanford; e "GSS ≥ 2", quando um GSS (pontuação de suscetibilidade genotípica) máximo calculado foi ≥2 ou ≥3, contando apenas as drogas disponíveis no Brasil e nos EUA em determinados anos civis. As tendências temporais de resistência foram analisadas pelo teste de Cochran-Armitage. Observamos uma diminuição na taxa de mutações de resistência para IP, NRTI, “IAS – mutações de classe 3” e “Nenhum medicamento totalmente suscetível” ao longo desses 11 anos, de 69,2% para 20,7%, 92,3% para 90,2%, 46,2% para 22,5% , e 12,8% para 5,7%, respectivamente (p < 0,05). A resistência aos NNRTI aumentou de 74,4% para 81,6%, principalmente por causa da mutação K103N. O escore GSS ≥2 aumentou durante os anos de 35,9% para 87,3% (p < 0,001) Demonstramos que a resistência aos IP e às três principais classes simultaneamente está diminuindo, embora o número de pacientes em uso de terapia antirretroviral tenha dobrado nos últimos dez anos no Brasil (125.000 em 2002 para 400.000 em 2014). e a disponibilidade de mais opções terapêuticas pode ter influenciado esse declínio. a facilidade na resistência aos NNRTI pode limitar esta classe como tratamento de primeira linha no Brasil no futuro.engUniversidade Federal de Minas GeraisUFMGBrasilMED - DEPARTAMENTO DE CLÍNICA MÉDICAThe Brazilian Journal of Infectious DiseasesHIVAntirretroviraisEpidemiologiaHIVAntiretroviralGenotypingResistanceEpidemiologyTrends and predictors of HIV-1 acquired drug resistance in Minas Gerais, Brazil: 2002-2012Tendências e preditores de resistência adquirida a medicamentos pelo HIV-1 em Minas Gerais, Brasil: 2002-2012info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articlehttps://www.scielo.br/j/bjid/a/gJVjZZMBFHLzqKmFq35Fg5z/?format=html&lang=enHelena DuaniAgdemir Waleria AleixoUnaí Tupinambásapplication/pdfinfo:eu-repo/semantics/openAccessreponame:Repositório Institucional da UFMGinstname:Universidade Federal de Minas Gerais (UFMG)instacron:UFMGLICENSELicense.txtLicense.txttext/plain; charset=utf-82042https://repositorio.ufmg.br/bitstream/1843/47681/1/License.txtfa505098d172de0bc8864fc1287ffe22MD51ORIGINALTrends and predictors of hiv-1 acquired drug resistance in minas gerais, brazil 2002-2012.pdfTrends and predictors of hiv-1 acquired drug resistance in minas gerais, brazil 2002-2012.pdfapplication/pdf1294712https://repositorio.ufmg.br/bitstream/1843/47681/2/Trends%20and%20predictors%20of%20hiv-1%20acquired%20drug%20resistance%20in%20minas%20gerais%2c%20brazil%202002-2012.pdfa9be48ffcb98ec3d9029c1e71a96b562MD521843/476812022-12-01 21:12:39.092oai:repositorio.ufmg.br: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Repositório de PublicaçõesPUBhttps://repositorio.ufmg.br/oaiopendoar:2022-12-02T00:12:39Repositório Institucional da UFMG - Universidade Federal de Minas Gerais (UFMG)false |
dc.title.pt_BR.fl_str_mv |
Trends and predictors of HIV-1 acquired drug resistance in Minas Gerais, Brazil: 2002-2012 |
dc.title.alternative.pt_BR.fl_str_mv |
Tendências e preditores de resistência adquirida a medicamentos pelo HIV-1 em Minas Gerais, Brasil: 2002-2012 |
title |
Trends and predictors of HIV-1 acquired drug resistance in Minas Gerais, Brazil: 2002-2012 |
spellingShingle |
Trends and predictors of HIV-1 acquired drug resistance in Minas Gerais, Brazil: 2002-2012 Helena Duani HIV Antiretroviral Genotyping Resistance Epidemiology HIV Antirretrovirais Epidemiologia |
title_short |
Trends and predictors of HIV-1 acquired drug resistance in Minas Gerais, Brazil: 2002-2012 |
title_full |
Trends and predictors of HIV-1 acquired drug resistance in Minas Gerais, Brazil: 2002-2012 |
title_fullStr |
Trends and predictors of HIV-1 acquired drug resistance in Minas Gerais, Brazil: 2002-2012 |
title_full_unstemmed |
Trends and predictors of HIV-1 acquired drug resistance in Minas Gerais, Brazil: 2002-2012 |
title_sort |
Trends and predictors of HIV-1 acquired drug resistance in Minas Gerais, Brazil: 2002-2012 |
author |
Helena Duani |
author_facet |
Helena Duani Agdemir Waleria Aleixo Unaí Tupinambás |
author_role |
author |
author2 |
Agdemir Waleria Aleixo Unaí Tupinambás |
author2_role |
author author |
dc.contributor.author.fl_str_mv |
Helena Duani Agdemir Waleria Aleixo Unaí Tupinambás |
dc.subject.por.fl_str_mv |
HIV Antiretroviral Genotyping Resistance Epidemiology |
topic |
HIV Antiretroviral Genotyping Resistance Epidemiology HIV Antirretrovirais Epidemiologia |
dc.subject.other.pt_BR.fl_str_mv |
HIV Antirretrovirais Epidemiologia |
description |
Several studies show that the prevalence of multidrug-resistant HIV-1 virus is declining over time. A retrospective cohort study was carried out to evaluate the trends of drug resistance in antiretroviral treatment-exposed individuals in a state of a middle-income country, Minas Gerais, southeast region of Brazil. We analyzed 2115 HIV-1 sequences from 2002 up to 2012, from 52 cities of Minas Gerais. The groups were analyzed according to the definitions: “IAS– 3 class mutations”, if ≥1 drug resistance mutation from IAS 2015 list (DRM) was present in each class; “No fully susceptible drugs” as the absence of any fully susceptible drug in Stanford algorithm; and “GSS ≥ 2", when a maximum calculated GSS (genotypic susceptibilityscore) was ≥2 or ≥3, counting only drugs available in Brazil and USA at given calendar years. Time trends of resistance were analyzed by Cochran–Armitage test. We observed a decrease in the rate resistance mutations for PI, NRTI, “IAS – 3 class mutations”, and “No fully susceptible drugs” over these 11 years, from 69.2% to 20.7%, 92.3% to 90.2%, 46.2% to 22.5%, and 12.8% to 5.7%, respectively (p < 0.05). Resistance to NNRTI increased from 74.4% to 81.6%, mainly because of K103N mutation. The GSS score ≥2 increased during the years from 35.9% to 87.3% (p < 0.001). We demonstrate that resistance to PI and to the three main classes simultaneously are declining, although the number of patients on of antiretroviral therapy has doubled in the last ten years in Brazil (125,000 in 2002 to 400,000 in 2014). Broader resistance testing and the availability of more therapeutic options might have influenced this decline. The increase in NNRTI resistance can limit this class as first line treatment in Brazil in the future. |
publishDate |
2017 |
dc.date.issued.fl_str_mv |
2017 |
dc.date.accessioned.fl_str_mv |
2022-12-02T00:12:38Z |
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2022-12-02T00:12:38Z |
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info:eu-repo/semantics/publishedVersion |
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info:eu-repo/semantics/article |
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article |
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publishedVersion |
dc.identifier.uri.fl_str_mv |
http://hdl.handle.net/1843/47681 |
dc.identifier.doi.pt_BR.fl_str_mv |
https://doi.org/10.1016/j.bjid.2016.11.009 |
dc.identifier.issn.pt_BR.fl_str_mv |
16784391 |
dc.identifier.orcid.pt_BR.fl_str_mv |
0000-0001-6833-3870 |
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https://doi.org/10.1016/j.bjid.2016.11.009 http://hdl.handle.net/1843/47681 |
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16784391 0000-0001-6833-3870 |
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eng |
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The Brazilian Journal of Infectious Diseases |
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openAccess |
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Universidade Federal de Minas Gerais |
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UFMG |
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Brasil |
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MED - DEPARTAMENTO DE CLÍNICA MÉDICA |
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Universidade Federal de Minas Gerais |
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